Provider Demographics
NPI:1598447195
Name:REBELES, NAOMI JESSICA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:JESSICA
Last Name:REBELES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4018 WATERCOVE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3041
Mailing Address - Country:US
Mailing Address - Phone:956-754-0742
Mailing Address - Fax:
Practice Address - Street 1:4018 WATERCOVE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3041
Practice Address - Country:US
Practice Address - Phone:956-754-0742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027837363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health